Triggering for submaximal exercise level in gastric exercise tonometry: Serial lactate, heart rate, or respiratory quotient?

Johannes A. Otte*, Ellie Oostveen, Peter B.F. Mensink, Robert H. Geelkerken, Jeroen J. Kolkman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
2 Downloads (Pure)

Abstract

Gastric exercise tonometry is a functional diagnostic test in chronic gastrointestinal ischemia. As maximal exercise can cause false-positive tests, exercise buildup should be controlled to remain submaximal. We evaluated three parameters for monitoring and adjusting exercise levels (heart rate [HR], respiratory quotient [RQ], and serial lactate measurements) in 178 tests in both healthy volunteers and patients suspected of gastrointestinal ischemia. Exercise levels above submaximal occurred in 20% of HR-, 2% of RQ-, and 5% of lactate-monitored tests (P<0.05 for HR vs. RQ and lactate). Low levels were seen in 5% of HR-, 10% of RQ-, and 41% of lactate-monitored tests (P<0.01 for lactate vs. HR and RQ). High levels resulted in 43% false-positive tonometry results compared to 19% of all tests (P<0.001); low levels did not result in more false negatives (5% vs. 6%). Although RQ monitoring yielded the greatest proportion of optimal exercise tests, serial lactate monitoring is our method of choice, combining optimal diagnostic accuracy, low cost, and simplicity.

Original languageEnglish
Pages (from-to)1771-1775
Number of pages5
JournalDigestive Diseases and Sciences
Volume52
Issue number8
DOIs
Publication statusPublished - 1 Aug 2007
Externally publishedYes

Keywords

  • Chronic gastrointestinal ischemia
  • Diagnosis
  • Exercise level
  • Exercise test
  • Gastric exercise tonometry
  • Tonometry

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